Harvard University

Eating Concerns Hotline and Outreach (ECHO) is one of five undergraduate peer-counseling groups at Harvard. The group staffs a hotline from 8 p.m. to 8 a.m. every day of the week and staffs its office in the basement of a dorm from 8 p.m. to 11 p.m. Sunday through Wednesday. It also hosts occasional outreach events (e.g., speakers, panels, discussions, Love Your Body Day study break).

ECHO was formed initially as Eating Problems Outreach at the initiative of students in the mid-1980’s. Like all of the peer counseling groups, the organization is administratively housed under the umbrella of University Health Services, which provides its funding (for the phone line, publicity, food for outreach events, etc.). The group is supervised by a clinician from the Mental Health Service (MHS) of UHS and by a counselor from the Bureau of Study Counsel, a campus resource for students around their learning, growth, and development. Students meet once a week in a supervision group (“supe group”); attendance at that group is mandatory. In supe group, staffers reflect upon calls and drop-ins and to consider the challenges the staffer faced in their effort to listen and respond. The premise is that we are always growing and developing in our capacity to listen and respond with attunement and that it is by reflecting on our efforts that we deepen our capacity to respond in ways that leave the other person feeling understood.

The supe group also serves as a place where staffers check in briefly with one another about their own lives. While it is not a therapy group or support group, in a place like Harvard, where students experience great pressure to be polished and performing, it offers a chance for students to let their hair down and be authentic about their experience at Harvard and beyond. In that sense, the supe groups serve a humanizing function for their members, which seems to be part of how students learn to tolerate and accept human vulnerability without feeling they have to resort to delivering too-simple advice or too-limited problem-solving. The experience of listening to and attuning to one another seems to be in the service of their learning how to keep others company in their distress.

Beyond the weekly supervision group, the staff members also participate in 35 to 40 hours of training/orientation during a week in the fall and another training/orientation session in January.

Beyond the counseling staffers do on the phone or in their office, the students also provide a lot of what they call “out-of-office business,” which means servingin vivoamong their peers (e.g., in a dorm, on a team, in an extracurricular group, in a class) as people whom friends and associates approach about their own eating concerns or with concerns about the eating patterns of a friend, lover, roommate, or teammate. There has been in recent years an increasing amount of out-of-office business. It seems that in a day and age where little is private (with Facebook, etc.) and where students are incredibly overcommitted, students are reluctant to be emotionally vulnerable with one another or to “burden” friends by asking for time to talk about what is troubling them. Peer counselors seem to be experienced by their peers as students whom they can trust and as people who are willing and available to listen.

While ECHO is not just a referral service, they are successful at making referrals. Many callers and drop-ins follow up on an ECHO staffer’s recommendation to speak with a clinician at MHS or a counselor at the Bureau. Our assumption is that referrals from a peer are trusted referrals and that, because callers and drop-ins are by definition speaking with a staffer at night, when ECHO is open and when people with eating issues tend to be especially vulnerable, the referral might be made and received at a point where a student is in a heightened state of readiness and therefore inclined to follow up on a referral.

Sheila M. Reindl, Ed.D

Associate Director, Bureau of Study Council

Harvard University

University of New Hampshire

Eating Concerns Mentoring program (ECM) is a peer-education group housed through the University of New Hampshire’s Health Service’s Office of Health Education & Promotion. The office provides funding for the group and is supervised by the office’s nutrition educator who is a Registered Dietitian (RD). The group provides peer-to-peer support for students on campus who are struggling with body image or disordered eating issues. The group also sponsors educational and outreach events including films and discussions, residence hall programming, Fat Talk Free Week, National Eating Disorders Awareness Week, and educational tabling. Group meetings are held on a bi-weekly basis.

Members are recruited in the fall, and go through a semester-long orientation period. During this time, they participate in educational and outreach events. This allows new members to get comfortable and confirm their commitment to the group. They also attend meetings with guest speakers, including a physician, psychologist, wellness counselor, and dietitian who specialize in eating disorders. This familiarizes mentors with campus resources so they can refer mentees to the appropriate resources.

At the beginning of the next semester, new members participate in formal training. The information presented includes medical, nutritional, and psychological aspects of eating disorders. Members are also educated about mentoring skills and risk factors for the development of eating disorders. By the end of this formal training, the peer leaders and advisor assess the new member’s ability to begin mentoring.

Students seeking help can connect with us through the Health Services website, by completing a short online form. This form is then sent to the peer leaders and staff advisor. Qualified mentors are then paired with a mentee. ECM offers support to students struggling with disordered eating or body image issues, and to those concerned for a friend or family member.

The contact between the mentor and mentee may be via phone, e-mail or in person. The mentee selects the desired form of communication. After every communication, a contact form is filled out by the mentor. The form is then sent to the ECM advisor. This document evaluates the progress and tracks the communication between the pair.

ECM also has programs that are available for residence halls, sororities, or other campus groups by request. Program topics include body image and the media, and mindfulness. Some members of the group are also trained in, and actively involved in the Reflections Body Image Program, an evidence-based program that promotes self-acceptance and positive body image in the female population. This program was originally piloted in sororities, and is now being expanded to other student groups.